Bipolar Disorder in Children: Part 1

OK, I admit it. I once didn’t believe that
bipolar disorder existed in children. Maybe this was wishful thinking on my
part. Maybe I just didn’t want to believe that the severe pain that I suffered
should ever be visited on a child.

Regardless, I now have learned more and
know better. I have spoken to doctors, parents of mentally ill children, and
have even a met a person who was diagnosed with bipolar disorder as a child. I
can now say that yes, bipolar disorder does exist in children.

Facts on Bipolar Disorder in Children

Unfortunately, we know little about bipolar
disorder in children as not only is it rare but it has only recently been
recognized. What is currently thought is that between 0.2-0.3
percent of children have bipolar disorder type 1 and it’s present in about
1 percent of adolescents (this is the same number as in the adult population).
However, recent estimates are that between 20-30 percent of adults with bipolar
type 1 began showing symptoms under the age of 20.

Diagnosing and Treating Bipolar Disorder in Children

The Diagnostic and Statistical Manual of
Mental Disorders (DSM) doesn’t differentiate between childhood and adult
bipolar disorder. This is, honestly, because we don’t know how to accurately
diagnose bipolar disorder in children. We really don’t know exactly how it
presents, so psychiatrists who specialize in this area must use their own
clinical judgement, experience and the diagnostic criteria seen in adults for
diagnosis. Children often receive a diagnosis of bipolar
disorder not otherwise specified (NOS).

It is recognized that moods are harder to
diagnose in children with irritability, tantrums and other behaviours being
normal in some degree for some children. It’s also known that the classic
symptom cluster of mania (racing thoughts, pressured speech, hypersexuality,
and grandiosity) is less likely to clearly occur in children. Children also
vacillate more frequently between mood states than adults. In children and adolescents,
it’s also known that a depressed
mood can manifest as irritation.

Medication treatment of children with
bipolar disorder is the same as adults: mood stabilizers, anticonvulsants,
antipsychotics, and other medications. Most parents try many forms of therapy
before resorting to medication of their children.

In
part two, I will discuss the prognosis for those with childhood bipolar
disorder and give real-life examples of what childhood bipolar disorder really
looks like.